Simple Ideas

Hazard Communication

Blogging | April 22, 2011

Telling people possibly frightening news in a way that doesn't make the situation worse. That is perhaps a workable definition of hazard communication.

I took my hazard communication class from an MD. He trained me how to communicate possibly scary news from the government to the public. But he picked up his skills while telling that kind of news to patients. It's a dicey process. But the better you do it, the more likely you can get a favorable outcome.

So that was the problem facing the team of docs standing in front of me. They had to let me know the news in a way that didn't flip me out. Tough stuff, because I'm wound rather tightly to begin with. It doesn't take much increase pressure to achieve a steady boil.

They had to tell me that my pleasant day surfing had now turned into something else altogether. I'd broken the front of my skull. Anterior sinus. There were loads of possible complications as I just had sea water (and rafts of sea going bacteria) leak into my head. There were a number of high priority issues they had to get me to grasp.

Meningitis. Uh yeah, that got my attention. They needed to get an IV going. Ok, get it going. Then sinus infections. They might need to block up part of my sinuses. There were possibilities of blockages occurring over the next 10 years. I'd need to see them once a week for a month, once a month for a year, once a year for 10 years.

That was presuming that the surgery went well. I got the message. They had to convey the seriousness of the situation, but not send me into orbit. They were able to do that.

I'd never been admitted to a hospital before as an in-patient. This would be new. They were talking Monday for surgery now. They talked about possible Sunday surgery, so I was not eating. But eventually they sorted it out and said Monday was fine. Ok, that was sort of good news. I wasn't in imminent danger.

But I was racing. My blood pressure is normally 110 over 70. It was 150 over 120. Part of that I expect was my body doing the fight or flight thing, I suspect. Adrenals kicking in, etc. But I know another part was the realization that I wouldn't be able to work Monday, and they were saying no work for a week. That was the biggest hurdle to get over. I was lead instructor for a two week class, My original coteacher was out with surgery of her own. I had two back ups, but one hadn't taught the class in a year...and was now going to have to solo teach the first week of our toughest class, without much preparation. Ugh. And oh yeah, the person I was dropping this on was my department chair.

As not too swift career moves go, this should not go unnoticed.

So there was that side of the equation. I was down hard and steaming because I was incapacitated. Too many years of football and basketball and the like telling me to get back up when I get knocked down. But I couldn't get back up until I got through surgery.

This was inconvenient.

I was given time though. Lots of time. Time to sit in a bed and watch. And listen. I observed dozens of cases over the course of my 8 hours in ER. A couple near death. A few brought in on backboards after vehicle accidents.

In every case the level of caring and professionalism was unparalleled. The same caution that was used with me, the same attention to detail that found the step fracture that could easily have been missed was displayed time and time again. I go to fast through life for this I thought. I miss details. I'd never thought I could do the job these people were doing, but now I saw in clearer detail exactly why I couldn't.

I want stories to have happy endings. In fiction I can control that. Here the ending is often determined before the first key is struck. That is a hard pill to swallow, but everyone who does this job seems to get it. They swallow that pill and still do their jobs.

And every time I saw them do their job, I was more overwhelmed with how they managed to care. It was a little easier for me to manage the viewing at a distance. I could watch and admire what they were doing from the back row of my bed and it was bearable.

I could watch them from afar and accept the scene before me. It was something else altogether when they were in my space. When it was me on the receiving end of all this caring. That wasn't me, was it? I couldn't be me on the receiving end of this much compassion. There had me well prepared for the other, for the hard news. I knew what the 7 foot board did to my skull and future. Those were the I thought the toughest pills to swallow.

But in the end, it was this communication that I couldn't choke down very well.


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